Medical Oncologist
CION Cancer Clinics
Hormone tablets and contraceptives before your operation | CION Cancer Clinics
You may be asked to pause the combined contraceptive pill or HRT before a major operation, because oestrogen raises the chance of a blood clot. Your surgeon and anaesthetist decide whether and when. This page explains which hormone tablets the team needs to know about, including period-delaying tablets and tamoxifen, what to ask about contraception, and how to recognise a clot afterwards. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Do you need to stop the contraceptive pill before surgery?
- Which hormone tablets does the team need to know about?
- How do the two main kinds of pill differ before surgery?
- What should you do once you have a surgery date?
- How do you recognise a blood clot after surgery?
- What do women and families believe about hormones and surgery?
- What do these terms mean?
- Common questions about hormone tablets before surgery
The short answer
Do you need to stop the contraceptive pill before surgery?
You may be asked to pause the combined contraceptive pill or hormone replacement therapy before a major operation, because oestrogen can raise the chance of a blood clot. Whether you stop it, and when, is decided by your surgeon and anaesthetist, so tell them about every hormone tablet you take.
Why hormones and surgery are discussed together
Lying still during and after an operation already slows blood flow in the legs. Oestrogen-containing tablets add to the tendency to form clots. A clot in a leg vein can travel to the lungs, which is serious. The team balances this risk against the problems of stopping the tablet, such as an unplanned pregnancy or return of menopause symptoms.
It depends on more than the tablet
The size of the operation, how long you will be less mobile, your weight, smoking, any past clot and the cancer itself all change the picture. For a small day procedure many people continue. For a large abdominal or pelvic cancer operation, the plan is often different.
What this page cannot tell you
It gives no timings for stopping or restarting any tablet. It cannot tell you whether your cancer makes hormone tablets unsuitable long term. Your treating team answers both.
Never stop a cancer hormone tablet such as tamoxifen on your own. Ask the doctor who prescribed it.Know your tablet
Which hormone tablets does the team need to know about?
Some of these are not thought of as medicines at all. Bring the strip or packet for each one to your pre-surgery check.
Combined contraceptive pill
Contains oestrogen and a progestogen. Brands in India include Ovral L, Mala D, Novelon, Yasmin and Femilon. This is the tablet most often paused before a major operation.
Hormone replacement therapy
Tablets, patches or gels for menopause symptoms. The team asks which form you use, because patches and gels may carry a different clot risk from tablets.
Tablets to delay or regulate periods
Norethisterone (Primolut-N, Regestrone) is often taken for a short time, for a wedding, festival or pilgrimage. Many women do not mention it, but the team wants to know.
Progestogen-only pills and hormonal coils are usually of less concern for clots, but still mention them.Cancer hormone treatment
Tamoxifen, letrozole, anastrozole and exemestane for breast cancer, or tablets and injections for prostate cancer. The prescribing oncologist and the surgical team agree the plan between them.
Also mention
- Fertility and IVF hormones
- Raloxifene for bone health
- Testosterone treatment
Not sure whether this applies to you?
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How do the two main kinds of pill differ before surgery?
Combined pill (oestrogen and progestogen)
Progestogen-only pill
Raises the chance of a blood clot
Little or no known effect on clot risk
Often paused before a major operation
Often continued, depending on the operation
If paused, you need another method of contraception
Keeps protecting you if continued as prescribed
Restart is timed by the team after you are moving about
Vomiting or fasting may still affect protection
Before the day
What should you do once you have a surgery date?
Tell the team early
Mention every hormone tablet, patch, injection or coil as soon as surgery is being planned. Pausing a tablet safely can take time, so the pre-anaesthetic check on the day before may be too late.
Ask about contraception
If your pill is paused, ask which other method to use. Condoms are a simple option. A pregnancy test is usually done before surgery, and an unplanned pregnancy can delay a cancer operation.
Ask about clot prevention
Ask whether you will have stockings, leg pumps or blood thinner injections around the operation. These are often used, especially if a hormone tablet was continued.
Get the restart plan in writing
Before discharge, ask when each tablet can restart and whether anything should change for good. Take this to your gynaecologist or oncologist.
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After the operation
How do you recognise a blood clot after surgery?
A clot in a leg vein usually shows up as pain, swelling, warmth or redness in one calf or thigh, often worse when you stand or walk. A clot that has reached the lungs causes sudden breathlessness, chest pain that is worse when you breathe in, a fast heartbeat or coughing up blood. Either needs same-day medical care.
Why it matters most after cancer surgery
Cancer itself makes blood more likely to clot, and so does a long operation on the abdomen or pelvis. When a hormone tablet is added, the chances rise further. This is why your team pays such close attention to what you take and how quickly you get moving.
What you can do
Walk as soon as the team says you may, even a few steps at a time. Drink the fluids you are allowed, wear stockings if they are given, and do not skip blood thinner injections if they are prescribed for home.
Who needs a specialist plan
Women with a past clot, a known clotting disorder, or breast or womb cancers that respond to hormones need a plan agreed with their oncologist and gynaecologist, not a general rule.
Commonly believed
What do women and families believe about hormones and surgery?
"A few tablets to delay my period do not count."
They do. Period-delaying tablets contain hormones, and the team needs to know about them, however short the course. Mention them at every appointment before surgery.
"If I stop the pill, I cannot get pregnant during that time."
Fertility can return quickly after stopping. Use another method of contraception for as long as your team advises, and tell them if there is any chance you are pregnant.
"Tamoxifen should be stopped by me before any operation."
Tamoxifen is part of cancer treatment. Any pause is agreed between your oncologist and surgeon, weighing clot risk against interrupting treatment. Do not decide it alone.
"HRT patches and tablets are the same thing."
They contain similar hormones but may carry different clot risks. Tell the team exactly which form you use.
Words you will hear
What do these terms mean?
- DVT
- Deep vein thrombosis, a blood clot in a deep vein, usually in the leg.
- Pulmonary embolism
- A clot that has travelled to the lungs. It needs urgent treatment.
- VTE
- Venous thromboembolism, the umbrella term for both of the above.
- Oestrogen
- The hormone in combined pills and most HRT that raises clot risk.
- Progestogen
- A hormone in both kinds of pill, coils and period-delaying tablets.
- Hormone receptor positive
- A cancer whose growth is driven by hormones. It may change whether hormone tablets suit you later.
Questions we are asked
Common questions about hormone tablets before surgery
How long before surgery should I stop the pill?
There is no one answer for everyone. It depends on the type of pill, the operation and your own clot risk. Your surgeon or anaesthetist sets the timing. Raise it as soon as surgery is planned, so there is time to pause it and arrange other contraception if needed.
Do I need to stop the pill for a small procedure like a biopsy?
Often not, because a short procedure with quick recovery carries a much lower clot risk. The team still needs to know you take it. Mention it at booking and let them decide, rather than assuming either way.
I am on tamoxifen and need another operation. What happens?
Your oncologist and surgeon discuss it together. They weigh the clot risk from tamoxifen and the operation against a short break in treatment. Some people pause, others continue with extra clot prevention. Ask both doctors and make sure they have spoken to each other.
Will I have a pregnancy test before surgery?
Usually yes, if there is any chance of pregnancy. It is routine and not a judgement. Anaesthetic drugs, scans and some cancer operations need to be planned differently in pregnancy, so the team needs to be sure.
Can I keep my hormonal coil in during surgery?
In most operations, yes. Hormonal coils release only a small amount of progestogen and are not usually linked with clots. For pelvic or womb surgery the surgeon may plan to remove it. Tell the team you have one, whatever the operation.
My menopause symptoms are bad without HRT. What can I do?
Tell your team if pausing HRT is hard. There may be options for a short time, such as a different form or non-hormone medicines. After cancer treatment, whether HRT suits you at all depends on the cancer type, so ask your oncologist.
What if I forgot to stop the pill as advised?
Tell the team as soon as you realise. It does not always mean a delay. The team may give extra clot prevention or change the timing. Telling them early gives them the most choices.
When can I restart my contraceptive pill?
Your team decides this after surgery, usually once you are walking about normally. The timing depends on your operation and your clot risk. Ask before discharge, and keep using another method of contraception until you have been told the pill is protecting you again.
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- NHS — Combined pill
- NHS — Hormone replacement therapy (HRT)
- NICE — Venous thromboembolism in over 16s (NG89)
- National Cancer Institute — Hormone therapy to treat cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Blood Thinner Injections After Cancer SurgeryHow clots are prevented after an operationWhen Do You Restart Your Regular Medicines?Getting paused tablets back on trackWhich Medicines to Stop Before Cancer SurgeryThe full list your team goes throughBreast cancer guideIf you take tamoxifen or letrozole
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